36D2301279 CLIA NUMBER - BROADVIEW HEIGHTS DANBURY

Laboratory Demographics

  • CLIA Code: 36D2301279
  • Facility Name: BROADVIEW HEIGHTS DANBURY
  • Facility Address: 9500 BROADVIEW ROAD
    BROADVIEW HEIGHTS, OH
    ZIP 44147
  • Facility Phone: 440 596-3047
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: SHANNON DOMANICH
  • NPI Number: 1881169472
  • Taxonomy: 1223G0001X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 36D2301279
LAB Type Assisted Living Facility
Facility Name BROADVIEW HEIGHTS DANBURY
Street 9500 BROADVIEW ROAD
City BROADVIEW HEIGHTS
State OH
ZIP 44147
Phone 440 596-3047
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/22/2024
Certificate Expiration Date 3/21/2026
Facility Type Assisted Living Facility
Lab Director SHANNON DOMANICH

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This page was last updated on: 9/29/2025